Sunday, May 20, 2012

Case of the Week 209

The following liver biopsy is from 6 year old girl. 
(CLICK ON IMAGES TO ENLARGE)

Hematoxylin and eosin (H&E), 200 times original magnification

 H&E, 400 times original magnification 

H&E, 1000 times original magnification
 
Based on these findings alone, what is your differential diagnosis?

The following object was found in the soil from the backyard where she frequently played.

 Unstained, object measures approximately 60 microns in diameter

Diagnosis?
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9 comments:

  1. AnonymousMay 21, 2012 at 2:57 AM

    Toxocara sp.

    ReplyDelete
  2. BillMay 21, 2012 at 8:21 AM

    Looks like Visceral Larva Migrans due to Toxocara canis or cati.

    She probably lives in the Southern US.
    One differential would be a liver invasion of Capillaria hepatica.
    Bill

    ReplyDelete
  3. Musigny1955May 21, 2012 at 8:23 AM

    Toxocara cati or canis, causing visceral larva migrans (thus the liver biopsy), in a child who accidentally the egg. Baylisascaris procyonis would be part of the differential however the Baylisascaris egg is larger, and in the biopsies I can't see any lateral alae.....

    ReplyDelete
  4. AnonymousMay 21, 2012 at 10:18 AM

    Ascaris lumbricoides

    ReplyDelete
  5. AnonymousMay 21, 2012 at 3:15 PM

    In opposition to the above mentioned I don´t think that the picture resembles Ascaris lumbricoides, because the outer cover is not undulated and the egg is not round enough.
    It is conceivable that the pictured item is not the cause of the lever granuloma.

    ReplyDelete
  6. AnonymousMay 22, 2012 at 6:23 AM

    the egg is relatively small for a Toxocara egg so I would go for Toxocara cati

    ReplyDelete
  7. SalbrentMay 22, 2012 at 8:57 AM

    Toxocara embryonated egg
    It's infectious, too
    Cool pic, thanks for sharing

    ReplyDelete
  8. AnonymousMay 22, 2012 at 2:57 PM

    Hello, I agree with the Toxocara egg in the last two pictures, but I think that the lever pictures showed another kind of egg, it is more oval than the other egg.

    ReplyDelete
  9. AnonymousMay 24, 2012 at 1:44 AM

    The picture of the liver is the larvae stadium

    ReplyDelete